Publication June 28th 2023

Darmstadt, June 28th 2023


Apo10 and TKTL1: key biomarkers in lung cancer screening

The search for innovative methods to distinguish malignant lung cancer from benign lung diseases is of great importance both for the early detection of cancer and for follow-up examinations of former patients.

A promising development in this field is the identification of biomarkers in macrophages from blood. A study from China published in Springer Nature in June 2023 examined the biomarkers Apo10 and TKTL1 in macrophages from 156 patients and subjects with lung cancer and 153 healthy controls. The results could fundamentally change the way we diagnose and monitor lung cancer.

The study used EDIM technology, which enables biomarker identification in macrophages. This approach has two advantages: first, tumor substances are not diluted in macrophages when they enter the bloodstream in this way, and second, macrophages can actively recognize and take up tumor cells.

Apo10, one of the two biomarkers, targets the protein DNaseX, which plays a crucial role in apoptosis, or programmed cell death. The accumulation of Apo10 in the blood can serve as an indicator of tumor development. The second biomarker studied, TKTL1, regulates glycolysis metabolism and is detectable at elevated levels in almost all malignant tumors. Thus, analysis of the two biomarkers can provide a picture of a patient’s malignancy.

For the study, 156 patients with lung cancer and 153 healthy controls were examined. The results show that the combination of Apo10 and TKTL1 levels – referred to as APT levels in the study – were significantly higher in the cancer group than in the control group. The diagnostic accuracy of this combination was high, with an area under the ROC curve (AUROC) of 0.9132. In comparison, other traditional tumor markers such as SCC, NSE, CyFra21-1, and CEA all scored significantly lower.

The results suggest that Apo10 and TKTL1 are promising biomarkers for identifying lung cancer patients as opposed to individuals with benign lung disease and may improve the diagnosis and monitoring of cancer patients.

To the full study on Springer Nature (paywall).


Anette Ludwig
Zyagnum AG
Gräfenhäuser Str. 26
64293 Darmstadt
Phone +49 173 769 68 22

About Zyagnum: The Darmstadt-based biotechnology company Zyagnum AG develops diagnostic solutions for human medicine. Zyagnum has a profound understanding of immunological processes and their connection with diseases. For example, the EDIM® technology developed by Zyagnum can be used in blood tests to detect specific antigens in immune cells that may play a role in tumour development. Today, the company employs more than 50 people and was founded by Zyagnum CEO Ralf Schierl together with Johannes Coy in 2007. 

About EDIM®: When the human organism derails and runs towards disease, the immune system is often the first to recognise this, often before any symptoms. The platform technology we have developed, EDIM® (Epitope Detection in Monocytes), uses the mechanisms of the immune system to detect such derailments. The EDIM® technology examines macrophages for antigens that have previously been taken up into the cell interior by these immune cells through phagocytosis – this is why we also call EDIM® an immunological biopsy.

About PanTum Detect®: The PanTum Detect® is based on EDIM® technology and detects the enzymes TKTL1 and DNaseX (Apo10) in macrophages. A large-scale study at the University Medical Centre Hamburg-Eppendorf was able to show that the PanTum Detect® can provide the decisive indication as to which people without typical symptoms and suspected cancer in a healthy screening benefit from further examination by imaging procedures. In the case of the 2022 study, an indication of a previously undetected cancer or precancerous lesion was provided for 124 subjects out of over 5,000 study participants – in the study alone for 29 different tumor entities (Positive Predictive Value: 82%).